Provider Demographics
NPI:1922592187
Name:BIRCH, CAROLINE (MD)
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:
Last Name:BIRCH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 GREENPOINT AVE STE 1B
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11222-2294
Mailing Address - Country:US
Mailing Address - Phone:476-251-2463
Mailing Address - Fax:
Practice Address - Street 1:112 GREENPOINT AVE STE 1B
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11222-2294
Practice Address - Country:US
Practice Address - Phone:476-251-2463
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-20
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD-23429208M00000X
NY313864207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist